How MSF teams treat malaria patients
28 September 2000
The most dangerous form of malaria, the one caused by falciparum parasites, tends over time to develop resistance to antimalarial drugs. In a new emergency situation MSF teams will collaborate with local health authorities in determining which drugs are most appropriate for treating cases. In many instances this information is known empirically (that is, from clinical experience) but in some instances it is necessary to carry out field testing of drug sensitivity. The drugs in common use for treatment include chloroquine, doxycycline, quinine and mefloquine. The proper management of malaria cases follows several steps:
training all health workers on the case definition of malaria - the usual one is "any a person with fever and chills";
promptly giving all people who meet the case definition presumptive treatment - so as to prevent the malaria infection from progressing to complications such as cerebral malaria;
admitting as inpatients anyone with symptoms of cerebral malaria and treating them immediately with an intravenous infusion of quinine and glucose. The latter element is important because many patients with cerebral malaria suffer from severe hypoglycaemia (low blood sugar); afterwards, educating families about how to avoid catching malaria in the future.